‘They follow the wants and needs of an institution’: Midwives’ views of water immersion |
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| Institution: | 1. Northern Ontario School of Medicine, Thunder Bay, ON;2. Department of Obstetrics and Gynaecology, University of Calgary, Calgary, AB;1. DGEPS, ESPUM, University of Montreal, Montreal, Canada;2. CR-CHUS, CIUSSS de l''Estrie – CHUS, Sherbrooke, QC, Canada;3. FMSS, University of Sherbrooke, Sherbrooke, QC, Canada;4. CR-IUSMM, CIUSSS de l''Est de l''Île de Montréal, Montréal, QC, Canada;1. Department of Women''s Health Karolinska University Hospital, Stockholm, Sweden;2. Division of Obstetrics and Gynecology, ep, Stockholm, Sweden;3. Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm Sweden;4. The Swedish Red Cross University College, Huddinge, Sweden.;5. Department of Clinical science, Intervention and technology, Karolinska Institutet, Stockholm, Sweden;1. Department of Clinical Science and Education, Karolinska Institutet, Stockholm Sweden, Sophiahemmet University, Box 5605, SE-114 86, Stockholm, Sweden;2. Department of, Stockholm Sweden;3. Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden;4. Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm Sweden, Sophiahemmet University, Box 5605, SE-114 86, Stockholm, Sweden, Head of University Department |
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| Abstract: | BackgroundA midwife’s ability to fully support women’s autonomy and self-determination with respect to midwifery care is often challenging. This is particularly true of water immersion for labour and birth. However, the woman’s agency over what happens to her body and that of her unborn baby should be key considerations for maternity care provision.ObjectivesA three phased mixed-methods study was undertaken to examine how water immersion policies and guidelines are informed. Phase three of this study captured the knowledge and experiences of Australian midwives, their support for water immersion and their experiences of using policies and guidelines to inform and facilitate the practice.MethodsCritical, post structural, interpretive interactionism was used to examine more than 300 responses to three open-ended questions included in a survey of 233 midwives. Comment data were analysed to provide further insight, context and meaning to previously reported results.FindingsFindings demonstrated a complex, multidimensional interplay of factors that impacted on both the midwife’s ability to offer and the woman’s decision to use water immersion under the themes ‘the reality of the system’, ‘the authoritative ‘others’’ and ‘the pseudo decision-makers’. Multiple scaffolded levels were identified, each influenced by the wider macro-socio-political landscape of Australian midwifery care.ConclusionsThe insight gained from examining midwives’ views and opinions of water for labour and birth, has aided in contextualising previously reported results. Such insight highlights the importance of qualitative research in challenging the status quo and working towards woman-centred practice and policy. |
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| Keywords: | Water immersion Water birth Informed choice |
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